How are mental representations of asthma triggers and symptoms related to interpersonal risk perceptions? A psychometric investigation of caregivers of children with asthma

Abstract

Objective

Parents and guardians (hereafter caregivers) make decisions for their children’s medical care. However, many caregivers of children with asthma struggle to understand their child’s illness. We used the psychometric paradigm to investigate how caregivers conceptualize, or mentally represent, asthma triggers and symptoms and how these representations are linked to perceived asthma exacerbation risk.

Methods

We asked 377 caregivers of children with asthma across the U.S. to rate 20 triggers or 20 symptoms along 15 characteristics. Caregivers also indicated their perceived risk of their child having an asthma exacerbation (hereafter interpersonal risk perceptions). Using principal components analysis, we extracted key dimensions underlying caregivers’ ratings on the characteristics. Then we related the triggers’ and symptoms’ scores on the dimensions to caregivers’ interpersonal risk perceptions.

Results

Interpersonal risk perceptions were higher for triggers with high ratings for the dimensions severe and relevant, and negative affect—yet manageable, but not chronic—yet unpredictable. Risk perceptions were also higher for symptoms with high ratings for the dimensions severe and unpredictable, and relevant and common, but not self-blame or manageable despite unknown cause.

Conclusion

By identifying key dimensions underlying caregivers’ mental representations of asthma triggers and symptoms, these findings can inform a new approach to asthma education.

Keywords:

• Asthma
• caregivers
• child
• risk perception
• psychometric

Author contributions

Erika A. Waters, PhD, MPH1 - CRediT: Conceptualization, Funding acquisition, Methodology, Supervision, Writing. Thorsten Pachur, PhD2 - CRediT: Conceptualization, Formal analysis, Methodology, Software, Visualization, Writing. Gabrielle Pogge, PhD3 - CRediT: Conceptualization, Data curation, Methodology, Software, Writing. Jean Hunleth, PhD1 - CRediT: Conceptualization, Writing. Gregory D. Webster, PhD3 - CRediT: Methodology, Writing. David A. Fedele, PhD, ABPP3- CRediT: Conceptualization, Writing. James A. Shepperd, PhD3 - CRediT: Conceptualization, Funding acquisition, Methodology, Project administration, Supervision, Writing

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The de-identified data, the analytic code used to conduct the analyses presented in this manuscript, and all materials used to conduct the study are freely available in the Open Science Framework public archive: https://osf.io/awqf8/?view_only=b965206c97684ab094e96e960826bf63

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research was supported by the U.S. National Institutes of Health [R01HL137680, Principal Investigators Erika A. Waters, James Shepperd].